2017, Vol. 1 Issue 2, Part A
Limb amputation in patients with diabetes: A clinical study
Author(s): Dr. Parijat Gupta
Abstract: Background: Diabetic foot ulcer is the common complication of uncontrolled diabetes with the prevalence of diabetes being four times more than any other complication. Diabetes leads to 4 million deaths per annum. The present study was conducted to determine the prevalence of amputations in study population. Materials & Methods: This study was conducted in the department of Orthopaedics which included 212 patients of both gender above 18 years of age. Patients with either type 1 or type 2 diabetes and coexisting DFU were included in the study. General information such as name, age, gender etc. were noted. All were informed regarding the study and written consent was taken. In all patients, WBC, serum creatinine, Serum calcium, phosphorus, C- reactive protein were recorded. Results: Out of 212 patients, males were 102 and females were 110. The difference was non- significant (P-1). Type I DM was present in 42 patients and type II DM was present in 170 patients. 92 patients had ischaemic ulcers and 120 had non- ischaemic ulcers. Patients with minor amputations were 32 having ischaemic ulcers (21) and non-ischaemic ulcers (11), major amputations were 102 having ischaemic ulcers (36) and non-ischaemic ulcers (66) and indigenous ulcers were 78 having ischaemic ulcers (35) and non-ischaemic ulcers (43). The difference was significant (P< 0.05). HbA1ac level in patients having ischaemic ulcers was 8.6% and in patients having non- ischaemic ulcers was 9.2%. CRP level was 36.8 and 70.2 respectively. Serum calcium level was 9.3 g/dl and 8.7 g/dl respectively. Serum creatinine level was 156.2μmol/L and 124 μmol/L respectively. GFR level was 58.4 ml/mim and 64.6 ml/min respectively. Albumin level was 38 g/l and 35 g/l respectively. Conclusion: Diabetes is a multifactorial and multiorgan disease affecting large amount of population. Diabetic foot is a complication in patients with uncontrolled diabetes. Amputation in diabetic foot patients requires a major decision.